DIRECTORATE OF MEDICAL EDUCATION

GOVERNMENT OF KERALA, THIRUVANANTHAPURAM

INSPECTION PROFORMA FOR PARAMEDICAL COURSES IN KERALA

(Inspection as per the order No)

I. DETAILS OF THE INSTITUTION
1. Name of the Institution with full Postal address. :
(with Telephone No, Mobile no&E mail)

2. Administrative status of the Institution

(Society/Trust/Institution or any other)

3. Head of the Institution/College (Designation)

Name:
Address:

Phone no :
Email ID :
3. Name of the Person to whom communication is to be sent:
(with Telephone No, Mobile no&E mail)

4. a) Location of the Institution

(Road and Railway route to reach the Institute / college):
b) Whether the Institute belongs to the jurisdiction of
Corporation/Municipality/Panchayath

5. Name of the authority or public body that

(a) Finance to the Institute
(b) Manages funds for the course that applied for

6. Name of the University with which the college is affiliated:

(for the existing courses)
SNo
1
2

Name of the course

Name of the university

7. Details of other Courses being conducted in the Institute/College

SNo

Name of the
course

Duration
of the
course

No. of
seats
sanction
ed

Year of
starting the
course

Furnish the details of Govt.Order with a

copy ,if any
Letter of intent

Letter of Permission

1
2
3
4
5

II. Details of the New Course applied for in the Institute/College

SNo

Name of the course

Duration
of the
course

No. of
seats
applied
for

Month &
Year of
starting
the course

Furnish the details of Govt.Order

sanctioning the course with a copy
(1)

a. Name of the University with which the college is affiliated:

(For the New course applied for)
b. Furnish the details of Affiliation
(Attach the copy of Affiliation letter)

c.

DETAILS OF INSTITUTION / COLLEGE

1) Whether the agency is a registered Society

(Attach copy of registration certificate)

2) Whether the place/Institute belong to the Jurisdiction of

Corporation/Municipality/Panchayath
3) Name of the Village, Taluk and District in which the
Institute is proposed.
2

(2)

4) Whether the Institute has already constructed

If yes, State the purpose for which it was constructed

5) Date of completion of construction

6) Total area of building-Plinth area

Living area
(Attach copy of Approved plan)

:
:

9) Whether the construction is as per the stipulation

of the Paramedical Council

10) Name of the Owner of the land

11) Survey No with sub division

12) Total area of the Land

13) Total area of the land meant for the particular course applied for:
14) Whether the Land is suitable for the Institute /College :
15) Whether the land area is as per the Minimum standard fixed for the course:
16) Whether the Applicant has their own building or not
If yes, give the following details

:
:

17) Total plinth area of the building

(Attach the approved plan of the building)

18) Total working area of the building

19) Total working area of the student's laboratories (1)

(2)
11) Total No. of Lecture Halls

12) Total working area of each Lecture Hall

13) Mention the other facilities in the building (Availability with area)
i) Library
ii) Common rooms
iii) Toilets
iv) Staff rooms
v) Auditorium
vi) Teaching aids
vii) Others

:
:
:
:
:
:
:
3

14) Whether the building meet the minimum standard

of the Paramedical Council or not

If Yes or No, Give Specific remarks.

III. DETAILS OF HOSPITAL FACILITIES AVAILABLE

a) Name and Address of the Hospital

b) Name of Owner of the Hospital

c) Road Distance from the College to the Hospital

d) No. of Beds

e) Total Out patient/Day

f) Total Inpatient/Day

h) Achievements of the Hospital

i) Name the Specialties available

(1)
(2)
(3)
(4)
(5)
(6)

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(7) -------------------------(8) -------------------------(9) -------------------------(10) -------------------------(11) -------------------------(12) --------------------------

j) Details of clinical works done per year for the last 2 years:

k) Details of Basic subject departments

Anatomy,
Physiology,
Pharmacology,
Pathology,
Microbiology

l) No. of Clinical Laboratories in the hospital

:
(Attach detailed facilities of the Clinical laboratories (as Annexure) in case of applying
for MLT courses .Furnish the details of No. of qualified lab technicians, Qualification
and experience, total no. of specimens / day, Average No. of specimens in each
laboratories in the last two years, Infrastructural facilities, Availability of work benches
to accommodate the trainees, Maximum No. of trainees possible to be accommodated etc
should be mentioned)

IV. DETAILS OF TEACHING STAFF FOR BASIC SUBJECT

Name of the
Occupant

Designation

Qualification

Experience

SubjectTeaching

Full
time/Part
time

(Attach separate list of faculties stating the Designation, Qualification, Experience, date
of joining, whether exclusively for the course and with their signature)
Remarks:

V. DETAILS OF TEACHING STAFF FOR THE SPECIALITY SUBJECT

Name of the
Occupant

Designation

Qualification

Experience

SubjectTeaching

(Attach separate list of faculties stating the designation, Qualification, Experience, date of
joining, whether exclusively for the course and with their signature)
Remarks:

Full
time/Part
time

VI. DETAILS OF NON-TEACHING STAFF

Name of the
Occupant

Designation

Qualification

Date of
Joining

Experience

(Attach separate list of faculties stating the designation, Qualification, Experience, date
of joining, whether exclusively for the course and with their signature)
Remarks:

VII.

a) Hostel facility available or not

b) Library; separate or combined with the main College:

VIII.

c) Details of books available for the course

(Attach list of Books separately)

d) Seating capacity of students

a). Equipments, Furniture, Glass wares, chemical and other requirements

(Attach List of equipments, Furniture, Glass wares, chemical and other
Requirements and also attach copy of purchase bill separately) :
b). Teaching aids like OHP, LCD, Charts models etc.
(Copy of bill to be attached)

IX.

Any other information:

X . Details of the Existing Paramedical Courses in the Institute /

College (in case of Periodic Inspection / Unnoticed Inspection /
...................)
SNo

Name of the courses for

which the inspection is
conducted

Duration
of the
course

No. of
seats
sanctioned

Month&
Year of
starting the
course

No.of
batches
admitted

1
2
3
a) MODE OF SELECTION AND CONDUCT OF THE COURSE
1)

No. of students admitted per year

2)

No. of students admitted by DME

3)

No. of students admitted by the Management :

4)

Total Fee collected from Govt. merit students :

5)

Total Fee collected from Management students

b) Remarks regarding the conduct of the course

1) No. of students present in the first year

2) No. of students present in the second year

3) Theoretical training in the first year

4) Theoretical training in the Second year

5) Practical training in the first year

6) Practical training in the second year

7) Conduct of examination

8) Maintenance of Practical record

9) Maintenance of Log book

10) Availability of teaching staff during the last 2 years:

11) Details of infrastructural faciities
7

No.of
batches
Passed out

c) Feedback from the students

1) Theoretical training

2) Practical training

3) Hospital posting
4) Conduct of Examination

5) Hostel / Food

6) Transportation

XI. Specific Remarks of the Inspectors:

Name, Designation and Signature of Inspectors

1) .

2) .